9.3 Medical Devices and Medically Necessary Liquids

9.3 Medical Devices and Medically Necessary Liquids

Quick answer: TSA Cares and the Medical What Can I Bring list start from the same duty: all passengers and their property are screened. Travelers should inform the officer of a disability or medical condition — verbally, with the optional TSA Notification Card, or with medical documentation. Declare medically necessary liquids and pack reasonable quantities; oversized medically necessary liquids that alarm and test positive for certain chemicals may not be allowed. Attached insulin pumps and glucose monitors are generally not removed; extra screening is a self pat-down of the device and an explosives-trace (ETD) test of the hands. Pacemakers should not use the walk-through metal detector (WTMD). Lithium external medical devices must be carry-on. Ask for a Passenger Support Specialist (PSS) or Supervisory TSA Officer. Private screening is available.

This section is public medical-screening logic for the TAB, for English/SJT items about assisting the public, and for checkpoint work after hire. It does not teach SSI. It does not replace a physician. The final decision rests with the TSA officer on whether an item is allowed through the checkpoint.

Start by informing the officer

TSA's Disabilities and Medical Conditions page is built around notice. Before screening begins, the traveler (or a companion) may:

• Tell the officer about the condition or the device and where it is located
• Hand over the TSA Notification Card (optional, not a boarding pass and not a waiver)
• Offer other medical documentation

The card does not skip screening. It is a discreet way to start the right procedure. Screening still happens. If the traveler needs help, they may ask for a Passenger Support Specialist or a Supervisory TSA Officer. If the experience is not acceptable, they may ask for a supervisor at the checkpoint and may later contact the TSA Contact Center.

Private screening is available at any time, with a companion of the traveler's choice. A second officer of the same sex is present for private screening on the pat-down page. TSA will not request that a traveler expose a sensitive body area (breast, groin, or buttocks) during screening. Those sentences belong in the same toolkit as the Notification Card: dignity and security are both in the public rule.

Medically necessary liquids: declare, then screen

TSA allows larger amounts of medically necessary liquids, gels, and aerosols in reasonable quantities for the flight, but the traveler must declare them at the checkpoint for inspection. That is a 3-1-1 exemption, not a "no screening" pass. The public steps are:

1. Inform the officer that medically necessary liquids or medications are present.
2. Remove them from the carry-on and place them in a bin or bowl separate from other property, along with accessories — freezer packs, IV bags, pumps, and syringes.
3. Allow visual or X-ray screening and, if needed, explosives testing.
4. If a medically necessary liquid, gel, or aerosol alarms, additional screening is required. If the alarm cannot be resolved, the item may not be allowed.

TSA's Medical category repeats a hard limit that travelers miss: any oversized medically necessary liquids that alarm during screening, testing positive for certain chemicals, may not be allowed through the screening checkpoint. Some contact lens solutions contain chemicals that typically alarm; TSA recommends placing solutions over 3.4 ounces / 100 mL in checked baggage. "Medically necessary" is not a magic label that forces a chemical-positive bottle into the sterile area.

Accessories: ice packs, freezer packs, gel packs, and other coolants may be presented frozen, partially frozen, or melted to keep medically necessary items cool. They still get screened. Screening will never include placing anything into the medically necessary liquid. If officers cannot clear the item with screening technology, the traveler may be asked to open it for vapor analysis — still without inserting a tool into the medicine.

If the traveler does not want liquid medication X-rayed or opened, TSA takes additional steps to clear the liquid, and the traveler or traveling guardian receives additional screening, which may include AIT, a pat-down, and extra screening of carry-on property. Refusing a method is not refusing all screening.

Insulin, EpiPens, and inhalers are generally Yes / Yes on What Can I Bring, with the same declare instruction. Insulin pumps and supplies must be accompanied by insulin, and insulin in any form or dispenser should be clearly identified. Labels are recommended, not required, but they speed the process. Solid-pill medications must still undergo screening and may be tested for traces of explosives.

Devices attached to the body

Insulin pumps and glucose monitors. Inform the officer before screening begins and say where the device is. You will not be required to remove medical devices attached to your body. Disconnected devices may be screened by X-ray; if the traveler does not want X-ray, alternative screening is used. In standard lanes, an attached pump or monitor gets additional screening: a self pat-down of the medical device and a test of the hands for explosives trace. In TSA PreCheck® lanes, that extra screening is required only if the device alarms the WTMD or AIT.

Ostomies, medical ports, and catheters. The traveler can be screened without removing or exposing the pouch, port, or catheter. If more screening is needed, the traveler self-pats the device outside clothing, then an ETD of the hands; any further pat-down avoids the medical device.

Implants and internal devices, including pacemakers. Inform the officer. You should not be screened by the WTMD if you have an internal medical device such as a pacemaker. Consult a physician before flying. If the traveler declines AIT or alarms the WTMD, the officer conducts a pat-down. Do not send a pacemaker patient through the metal detector because the line is moving.

External devices (bone growth stimulator, spinal stimulator, neurostimulator, port, feeding tube, insulin pump, ostomy, and similar): inform the officer of the device and location. Submit it for X-ray if the traveler can safely disconnect. Check the manufacturer before X-ray, WTMD, or AIT. If the traveler cannot disconnect, expect additional screening; devices in sensitive areas get careful and gentle inspection. Ask for a PSS or supervisor if help is needed. Lithium in those devices: carry-on only, as section 9.2 stated.

Respiratory equipment. Not every airline allows a portable oxygen concentrator in flight — that is an airline and manufacturer question. If the traveler can disconnect, submit the concentrator for X-ray and continue to AIT or WTMD. If they must remain connected, the equipment is tested for explosives trace. Nebulizer liquids are exempt from 3-1-1. CPAP/BiPAP/APAP units may remain in their carrying case; in standard lanes they may still need to come out of the carry-on for X-ray.

What this looks like on an image, and on the floor

Medically necessary liquids are still liquids: dense bottles, gel packs, ice that may be melted. A pump is a small electronic brick plus tubing. Do not treat a declared insulin vial as a 3-1-1 failure, and do not treat an undeclared oversized bottle as cleared because the traveler later said "it is medical." Declaration starts the exemption. Alarm plus a positive chemical test can still deny the item.

Realistic scenario

A traveler approaches the standard lane with an insulin pump attached, a cooler of insulin and melted ice packs, a bottle of contact lens solution larger than 3.4 ounces, and a lithium external stimulator in a checked bag. The officer should be informed before screening — speech, Notification Card, or documentation. The pump stays on; the traveler self-pats the device and the officer swabs the hands. The insulin and ice packs are declared, placed in a separate bin with syringes, and screened without inserting anything into the vials. The contact lens solution is an oversized liquid that often alarms; if it alarms and tests positive for certain chemicals, it may be refused even though other medical liquids are allowed — TSA already recommends checking that size. The lithium stimulator is moved to carry-on; it is not a hold item. If the traveler has a pacemaker, they are not sent through the WTMD. If they want a quieter process, they request private screening and a PSS. The final decision rests with the TSA officer.